🚀 go-pugleaf

In article <17207@optilink.COM> cramer@optilink.COM (Clayton Cramer) writes:

[I have deleted the message to which Mr. Cramer was responding]

>In fact, health care was not left mainly in the market.  The 
>Medicare program dramatically increased the number of dollars
>spent on medical care in this country.  What happens when you
>increase the number of dollars chasing a good, without an
>expansion of the supply of the good?  The price goes up.
>
>In the early 1970s, Health Systems Agencies were established 
>by that liberal Nixon, and proceeded to exercise monopolistic
>powers over what equipment and facilities hospitals could 
>purchase.  Ostensibly, this was to save money.  The anticompetitive
>effects were so obvious that they were eventually abolished by
>Congress.
>
>The largest state in the U.S., California, adopted a more generous
>form of Medicaid/Medicare called Medical, which certainly played
>a major role, even when measured on a national scale, in the
>U.S. health system.
>
>"Left mainly in the market"?  No, not true, as usual.


   One interesting point to ponder is the effect of licensing laws
on restricting medical providers.  In the early part of this
century, the "allopaths" as they were inaccurately known, managed
to kill off almost all competition from other practitioners.  Only
osteopaths retained the right to earn a license to practice every
form of medicine (i.e., osteopaths not only did manipulative
medicine, but also practiced surgery, prescribed drugs, delivered
babies, etc.).
   Recently many professions have tried to expand their practices to
procedures currently restricted to medical doctors.  Optometrists
want the right to prescribe medicine to treat minor eye diseases.
This is vehemently opposed by ophthalmologists.  Podiatrists, who
can do foot surgery under the scope of their license, want to expand
to also do ankle surgery.  General surgeons are against this.
Nurse midwives can deliver babies in some states, in some states
they can't; they've run into fierce opposition from obstetricians.
Some non-medical mental health care workers have argued that they
should be allowed to prescribe psychiatric medicines.  Most of these
people could deliver services more cheaply than a physician, because
their training is less costly than a physician's and they wouldn't
need to carry the same overhead costs as a medical doctor.  The
question is, should licensing boards make the decision as to whether
a professional is competent to perform a service, or should the
consumer?
   Of course, this begs the question of whether we've had a truly
free market in medicine ever since ANY kind of license was
required to practice medicine!


Robert Cerpa
Graduate Group in Biophysics
cerpa@cgl.ucsf.edu